HomeMy WebLinkAboutCONSTITUTION AVE. S., 523
. BlJI1J}/[tlNG PERMIT
J!ifl~RECTllJN 5 I'
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ProjectDescripti~
tJEA/ VINyL SI:J>~I.
.Quj]'(llng ..IIPlumb~ngD-' Mech~llicalD 'Ai~l'r~lSp'~ig!<:I~:r::{J
_.u'.un__ ,___ _ _'I
.. .. . ..' '::,j)URiNG4NSPECTlONS THEBUILi.nNGPERMJT &APPROVrWPLANS SHi\:LLBEON:$lTE.<. ,. . .
PerIt1it#I!~-oK-1JJl:i;::g~-: - [p@@u@M@DtF~
F9r1nspectionsCaU (360) 473- 5870 ApproveJ Dale ,... Note~
PBJJIEct I!:!J~J;lIRD FRJ2NtTl:l~J!Jl~l!THER
- - .- -. .. -
Erosion Control In Plt/ce
1st Foumlation Footing (Cited.. Setbacks)
FOUNDATION Foundation 'ffalls
DO NOT POUR Plumbing Ground Work !
CONCRETE MeehanieM Ground Work
PRIOR TO APPROVAL Under Floor Framing .. ,
Footing Insulation '.1
- - -
Rou/?h )n "
2nd. PLUMBING,
Erhaust Fans/Duct
MECHANICAL Heating, Duct, Vent
GAS PIPE Support / Test / Meter set
.. -. . Fire Sp!,.inMer Line
r Shear & Hold Down Connections
FRAMING L&/ Electrical Approved
-- R oo.flCrawl/Ve ntilatio n
(lFlsT.& ZNl) ARE APPROVJlW) Framing 11 JJ Wi S-~ { {; ""i
- INSULAT;ON] -
r Llnder-:floor /.
Walls IJ IIJJIr (N/'x
-'1-..":" c.
Ceilii1g
. .
- -.-.- - --
,~.' I
.th .'
5 '...SUEETROCK (Fire Sprinkler must he approved prior 10 sheetrock) ____. .
1
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- -.- .." . . - -- --. --. ---- . -
.....~. FINAL ELECTRICAL 415-4000
Dept. '!lLabor & Industry
WA. TER MAINTENANCE 473-5927
Greme 71'<1/), flack Flow, H'ater Meiers
PlJBLlC I Drivew(/v AI'pr;)(lch 473-5270
JFORKS I SeH'<!l' C:'ollnec/iolJ 473-5270
~ ......-..~ -
KITSAP CO. HEALTH DISTRICT 337..5285
Septic Systems -
. . FIRE 473-5394
FINAL. BUILDING ,111 o//h" uj,Ul'e 111I/1/ be aPI)r!Jl'cd 473-5870 (ljjJ t-i6--( V
O('c~jpm][~~; ajJp'~ovq/.Ihr SFI? 'O11~1,.' - COJJJmercial S:lr/lcllff'eS I r.;(juire ({ .':.epura/(' Cer/{fh'ilh' or ~. ,.
, {J(:cuI>L.l/lci..'
DO NOT OCClJPY BUILDING \VHTHOUT BUILDING DEPAlnMENT APPROV AL
PROTECT THIS CARD FRO/If THE WEATHER
Rev AUgllst 2()()7
-~
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER: 8808 00282
DATE ISSUED: 05/06/2008
345 - 6th Street, Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER: 3790-005-005-0002
APPLICANT NAME: K-DESIGNER
OWNER NAME: GUELCHER WILLIAM & CHELSEA &
CONTRACTOR: K DESIGNERS
LENDER NAME:
ZONING: R10
PHONE: (180) 052-8954
PHONE:
PHONE: (916) 853-7400
PHONE:
SITE ADDRESS: 517 S CONSTITUTION AVE
ADDRESS: 8647 SOUTH 212 ST, KENT, WA 98031
ADDRESS: 7534 CHICO WAY NW, BREMERTON, WA 98312
ADDRESS: 2440 GOLD RIVER RD STE 100, GOLD RIVER, CA 95827
ADDRESS:
Building Permit
State Surcharge
$1 ~,338.96
$245.00 2211
$4.50 0236
$249.50
EXPIRATION: 11/02/2008
STATUS: ISSUED
SUBMITTED:
05/06/2008
VALUATION:
RESIDE A DUPLEX WITH VINYL SIDING
TOTAL FEES:
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
Square Footage: Bid Price from Applicant
1 TOTAL
Inspection Requests
DCD: Building Inspections
L&1: Department of Labor and Industries
(360) 473-5870
(360) 415-4000
Fire Inspections
HID: Bremerton, Kitsap County Health District
PW: Department of Public Works
(360) 473-5394
(360) 337-5285
(360) 473-5270
This permit shall become null and void if the described and authorized by this permit has not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned
at any time afterthe work is commenced for a period of 180 days. It is the responsibility of the permit holder to see that the required inspections are made. Failure to obtain required
inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton that the concealed work meets or exceeds code
requirements. Any demolition, testing, or financial burden shall be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City against any and all
responsibility or liability connected with the construction. I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel provisions of
any State or local law regulating construction or the performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the State
Contractor's Registration Law under Section 3, Chapter 126, Laws of 1967. All revisions to an approved plan require DCD review and approval priorto performing work. All building and tenant
occupancy permits are required to pass final in ~ection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy.
I have read, and agree to abide he conciitions of this permit including all conditions of zoning, building codes, and State and Federal laws.
SIGNATURE OF OWNER OR ~~ ~~
AGENT: - ,
PRINTED NAME: L'/a//~// r!-r:t: DATE:/';:~/CC}/ ;:; -:;;<000
CONDITIONS
City of Bremerton's approval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City
regulations does not necessarily ensure compliance with federal or state laws. /'----v
/'
10. (DCD-01)
DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency
(Clean Air Agency) and Washington Department of Labor and Industries (L&I) regulations
require an asbestos survey be performed to determine whether there are asbestos-
containing materials in the work area or structure. The asbestos survey must be
conducted by and EPA-certified (AHERA) building inspector (except renovation or owner-
occupied single family residences).DCD: For more information, please contact Clean Air
Agency through their web site at www.cleanair.org or by phone at 800-552-3565 or 206-
689-4058. The L&I web site can be found at www.lnLwa.gov/p-ts/asbestos/asbestos.htm.
DCD: Validity of permit. The issuance or granting of a permit shall not be construed to be a
permit for, or an approval of, any violation of any of the provisions of the Washington State
Building code or of any other ordinance of the City of Bremerton. Permits presuming to give
authority to violate or cancel the provisions of the Washington State Building code or other
ordinances of the City of Bremerton shall not be valid. The issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring
Li
10. (DCD-02)
Page 1 of 2
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PERMIT CENTER
CITY OF
BREMERTON
D lST 'f
Building Permit Application
Dept. of Community Development * 345 - 6th Street, Suite 600 * Bremerton * WA * 98337-1873
(360) 473-5275 * Fax (360) 473-5278
1:liB"i.tl:~;:~]~~;:IIO~llml.lr*ltMill;;;11::~D11ii~mit.ii~~~~:~]~:~:~:~:~:~:~:~~:~:~:j:~:~;;~ji:j:D~:~:l1ijf.IIi.1lJ::llgi.n:t~:~:~:I::~~~~j:~:j:~:j:~:j:~:j:~:j:~:j:~:~:~:j:~:~:~:j:~:~:~:~:~:~:~:~:~:~:~:~:1
Site Address:
S-~;< '5 5,)
COk'V c;-/d /J/tjLP,v7/
What is the application for? (Please check one)
D NEW SINGLE-FAMILY RESIDENCE
D NEW DUPLEX
D NEW MANUFACTURED HOME
D RESIDENTIAL REMODEL
D RESIDENTIAL ADDITION
0RESIDENTIAL REPAIR
D NEW COMMERCIAL
D COMMERCIAL REMODEL
D COMMERCIAL ADDITION
OWNER:
D COMMERCIAL REPAIR
D NEW MULTI-FAMILY
D TENANT IMPROVEMENT
D NEW GARAGE/CAR PORT
D NEW ACCESSORY BUILDING
D NEW SIGN
D STRUCTURE DEMOLITION
D GRADING (Cubic Yards:
D OTHER:
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE?
YESD .NO D
Scope of work proposed:
re~~
h---- ./A'
S'./ ~/?../
(/
V /""1_A/L
./
Square Footage: Dwelling:
Garage:
Decks:
Valuation Plan Review Fee Permit Fee Surcharge Total Fees
/7337/4k ~ '-I9,~-D
Application for which no permit is issued within 180 days following the date of application shall expire by limitation, and plans and other data
submitted for review may thereafter be returned to the applicant or destroyed by the building official. The building official may extend the time
for action by the ap Iicant for a period not exceeding 180 days on request by the applicant, showing the circumstances beyond the control of the
applicant h epreve ted action from being taken. No applicant shall be extended more than once. In order to renew action on an application
after Iration, the pplicant shall resubmit plans and pay a new plan review fee.
y:!- ~~~&r..
,/ Applicant's Signature~ ~
~ 4/ 1/ gf -<-< c;:cDcY
Date / .
. .
BtllLDIMGPERMIT
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Project Description
,,,P lA<.E. 3 LU-,~b(h
,~uil~i,Ilg,\I] Plumbing 0 Mechanical D Alarm/Sprinkler
" " ' "_~ ' " "l/U'-'~ __ ____, ' . "
,:fioUR.lN'G'INSPECTlONS THEBU lUHNG PERMIT &: ApPROVED 'pLANS SHALL BE0NSiTE'.
'.PerIijlt;~.<Jl~I'!!I ~ D~1'- . ~@@u @~'~d~~
For]lIsp~cti6tl'~,Can (~66) 473- 5.870 . . . , Approwd Date '. Notes.. .'
!!BllTE(;T:#'~(tjiJm:F~THE WYoJHER. R
-
INSULATION
Erosiol1 Control In Place
Foundation Footing (Chec;k Sethach)
Foundation Walls
Plumbing Ground Work
Mechanical Ground Work L
Under Flpor Framing
~'()oting Insulation..
ROllf.?h In
Exhaust Fans/Duct
Heating. Duct. Vent
Support / Test / Meter set
,'_ Fire Sprinkler Line.'
Shear & Hold Down Connections
L&I Electrical Approved
R oo.flCrawl/Ventitation
Framilw
1st
F8VNDATION
'])();NOT POUR
"CQNCRETE
. PRIOR TO APPROVAL
2ndh
l!LUMBING
MECHANICAL
"GASPIPE
'.9", . ,FRAMING
,.tn' t~T&2NI)AREA.PPRO.vED)
~......,..
TI
" . .t'h'" " ""~ .
:5....; . ',' ,.:
ii,.' . (SHEETROCK
'"
~'...'4'.'h.'..":':.",""."':'"
. ,. ',':.., ,"INAL
FINA'L ELECTRICAL
Dept. oIL/rbor & Industry
415-4000
'I"~)
WATER.MAINTENANCE
Grease Trup, Bade' Flow, Wuler Meters
PUBLIC Drivew;',iJ :.I!'pro(lch
WORKS Sewer Comi;~clio/l
'. 'KITSAP CO. HBA.LTH DfSTlUCr
473-5927
473-5270
473-5270
..
Septic Systems
frRE
337-5285
, ' , ,., ,~ ,'" .
FINAL.Bl:fll;Df NG At! olllte ab;",e ml/sl he; ([('pl'rlved
, , , ' ;';; ,', , ; , '- - , , , ,',' .':, " " ~, -, ,
()/dll?'Uj'1(~\:",(.,I;Jj);,';)ycj{ji,)!" :SFR pn,(F '- COfnniercia/ structures lYN/uire (I sepoFale 'Ccrlll'call: q/
eiCu!,an<.T; . .' .
473-5J9{i
47i'5S70 1~12J/.
.....
b'ti-~
'00 NOT OCCUPY BUILDING wrrHOUT BUILDINGDI~PARTMf;~NT APPROVAL
PROTECT TJIJ/;;CARD FROM THE WEATHER
Rev:'Augllst 2007
...... .,
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER: 8808 00227
DATE ISSUED: 04/04/2008
345 - 6th Street. Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER: 3790-005-005-0002
APPLICANT NAME: SRC
OWNER NAME: GUElCHER WilLIAM & CHELSEA &
CONTRACTOR: S R C INC
lENDER NAME:
SUBMITTED:
04/04/2008
VALUATION:
$5,139.36
Building Permit
State Surcharge
$113.00 2211
$4.50 0236
$117.50
TOTAL FEES:
Inspection Requests
DCD: Building Inspections
l&l: Department of Labor and Industries
SITE ADDRESS: 517 S CONSTITUTION AVE
ADDRESS: 923 MANOR DRIVE, BREMERTON, WA 98312
ZONING: R10
PHONE: (253) 208-7214
PHONE:
PHONE: (253) 208-7214
PHONE:
ADDRESS:
ADDRESS:
ADDRESS:
7534 CHICO WAY NW, BREMERTON, WA 98312
923 MANOR DR, TACOMA, WA 98467
EXPIRATION:
10/01/2008
STATUS: ISSUED
Building Permit. No Mechanical/Plumbing
9 RESIDENTIAL WINDOWS
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
Square Footage: Bid Price from Applicant
(360) 473-5870
(360) 415-4000
Fire Inspections
HID: Bremerton, Kitsap County Health District
PW: Department of Public Works
1 TOTAL
(360) 473-5394
(360) 337-5285
(360) 473-5270
This permit shall become null and void if the described and authorized by this permit has not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned
at any time after the work is commenced for a period of180 days. It is the responsibility of the permit holder to see that the required inspections are made. Failure to obtain required
inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton that the concealed work meets or exceeds code
requirements. Any demolition, testing, or financial burden shall be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City against any and all
responsibility or liability connected with the construction. I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel provisions of
any State or local law regulating construction or the performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the State
Contractor's Registration law under Section 3, Chapter 126, laws of 1967. All revisions to an approved plan require DCD review and approval prior to performing work. All building and tenant
occupancy permits are required to pass final inspection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy.
I have read, and agree to abide by the conditions of this permit including all conditions of zoning, building codes, and State and Federal laws.
~:\,~:;UREO'OWNEROR iL,-_- --== :=::--- J
PRINTED NAME: ~N~~ DATE: Lj'"'4~C) Y'
CONDITIONS
City of Bremerton's approval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City
regulations does not necessarily ensure compliance with federal or state laws.
DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency
(Clean Air Agency) and Washington Department of Labor and Industries (L&I) regulations
require an asbestos survey be performed to determine whether there are asbestos-
containing materials in the work area or structure. The asbestos survey must be
conducted by and EPA-certified (AHERA) building inspector (except renovation or owner-
occupied single family residences).DCD: For more information, please contact Clean Air
Agency through their web site at www.cleanair.org or by phone at 800-552-3565 or 206-
689-4058. The L&I web site can be found at www.lnLwa.gov/p-ts/asbestos/asbestos.htm.
DCD: Validity of permit. The issuance or granting of a permit shall not be construed to be a
permit for, or an approval of, any violation of any of the provisions of the Washington State
Building code or of any other ordinance of the City of Bremerton. Permits presuming to give
authority to violate or cancel the provisions of the Washington State Building code or other
ordinances of the City of Bremerton shall not be valid. The issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring
10. (DCD-01)
10. (DCD-02)
ji
~
Page 1 of 2
. "
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER: 8808 00227
DATE ISSUED: 04/04/2008
345 - 6th Street, Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER: 3790-005-005-0002
APPLICANT NAME: SRC
OWNER NAME: GUELCHER WILLIAM & CHELSEA &
CONTRACTOR: S R C INC
LENDER NAME:
ZONING: R10
PHONE: (253) 208-7214
PHONE:
PHONE: (253) 208-7214
PHONE:
SITE ADDRESS: 517 S CONSTITUTION AVE
ADDRESS: 923 MANOR DRIVE, BREMERTON, WA 98312
ADDRESS: 7534 CHICO WAY NW, BREMERTON, WA 98312
ADDRESS: 923 MANOR DR, TACOMA, WA 98467
ADDRESS:
SUBMITTED:
04/04/2008
APPROVED: 04/04/2008
EXPIRATION: 10/01/2008
STATUS: ISSUED
the correction of errors in the construction documents and other data. The building official
is also authorized to prevent occupancy or use of a structure where in violation of the
Washington State Building code or of any other ordinances of the City of Bremerton.
MINIMUM INSPECTIONS REQUIRED
To request an inspection, please call (360) 473.5870 and be sure to provide your permit number, name on permit, site address, contact
phone number, and inspection type.
Framing
Insulation
Final Inspection - Building
Page 2 of 2
~ @ ~ 0 'I!J ~RMIT CENTER
APR 0 4 2008
Building Permit Application
BREMERTON.-DEPT. OF
COMMUNITY DEVELOPMENT
Dent of Communi tv Development" 345 - 6th Street. Suite 600 " Bremerton "WA " 98337-1873
(360) 473-5275 " Fax (360) 473-5278
rDl
~Jill
Bel T Y 0 F II
REMERTO~
Bf50J OOZ-7-1
R,O
t) \~T g'
Site Address:
5d.~ 3- ~f)tvrhc)n Ayenue 1 (5r()fl}erfrn, Wit 9~Q/~
e.;f
CONTRACTOR: .
37/0.- L)D~ --- oo_~ - o~a '2..-,)
What is the application for? (Please check one)
D NEW 'SINGLE-FAMIL Y RESIDENCE 0 COMMERCIAL REPAIR
o NEW DUPLEX 0 NEW MULTI-FAMILY
o NEW MANUFACTURED HOME 0 TENANT IMPROVEMENT
[g--RESIDENTIAL REMODEL 0 NEW GARAGE/CAR PORT
D RESIDENTIAL ADDITION 0 NEW ACCESSORY BUILDING
D RESIDENTIAL REPAIR D NEW SIGN
o NEW COMMERCIAL D STRUCTURE DEMOLITION
o COMMERCIAL REMODEL 0 GRADING (Cubic Yards:
o COMMERCIAL ADDITION !5a'OTHER: ~1f>X Q..~
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE? YESD NO ~
Scope of work proposed: \f\J te ~ ---r' l) .~
Lu-l'\..v~ ~ I"'" t.v '\ V\ .~+- ~ 1 ~ -\-- .V\~____I
4-s L-v'n ~/v..e .or " 4 f JI l"C'f,;y ,"",,~ ck. .
Square Footage: Dwelling: 'd1.IfS)ir' Garage: if Decks:
Valuation Plan Review Fee Permit Fee Surcharge Total Fees
51)Q, ), f// //3.00 '1- ,- 0 117<~-o
....)
Application for which no permit is issued within 180 days following the date of application shall expire by limitation, and plans and other data
submitted for review may thereafter be returned to the applicant or destroyed by the building official. The building official may extend the time
for action by the applicant for a period not exceeding 180 days on request by the applicant, showing the circumstances beyond the control of the
applicant have prevented action from being taken. No applicant shall be extended more than once. In order to renew action on an application
after expiration, the applicant shall resubmit plans and pay a new plan review fee.
k-
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Lf- Lf '-0 r
MILGARD MANUFACTURING,..INC.
Clearly thebesf '
965 54TH AVENUE. E. . TACOMA, WA 98411 . 1-800-562-8444 . 1-206-922-6030.
"~'~'T"-~:;~:r:~::I'~~'~;s , '~;;'~~tF~;,~~~~J;~';~:
I shall fot be ~oristrued to ~ ~~ of the Intern tlooal
! of ; violBtlomOI the ~r ISI t thE! Cityiot a merton.
: COd'. or ~ny 0 her ordl," ~~ority to 'IIblate r ca!"cel
. Pe ts presu 109 to 91v a 'onal Codes! and .
. , . .....-;;wt'<<.sioos..l.Ht\&~ 1\.L,-.._-....~lInot
· tHS l"J"'~' 'I' c'~ emerton S"A1'
'ordlrpnces of ttle I 0: i'
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VINYL, ALUMINUM & WOOD WINDOWS. .FRENCH DOORS. SLIDING GLASS DOORS . SKYLIGHTS. GARDEN-AIRE WINDOWS.
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.leu I LDI NG ~ERM IT
~9
768
AI
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City of Bremerton, Washington
Phone: (206) 478-5281
OWNER'S VALUE BLDG. DEPT. VALUE PLAN CHECK FEE RECEIPT NO. PERMIT FEE RECEIPT NO. DATE
$ 63,000 --- $ 106.50 44604 $ 213.00 44790 1-.11-78
SITE ADDRESS I LOCATION 523 so. CONSTITUTION AVE.
OWNER'S NAME DANA & MI CHELLE CUTTWI96RESS
PHONE4 79-9929
CONTRACTOR
SAME
STATE CONTRACTOR'S L1C. #
ADDRESS
~ RESIDENCE
o BUSINESS
~ NEW
o REPAIR
PHONE
o REMODEL
o ADDITION
PLANNING I ZONING
R1
FIRE ZONE
3
STORIES
1
OCCUPANCY
I
THIS PERMIT ISSUED FOR:
DUPLEX PER APPROVED PLANS & DEPT. COMMENTS ATTACHED
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.
INSPECTIONS REQUIRED: Foundation ~
INSPECTION:
'Framing ~
Plumbing ~
Electrical ~
Wallboard ~
FINAL [XJ
FOR INSPECTORS USE ONLY:
REINSPECTION:
Io,PPROVED NOT
TYPE OF INSPECTION DATE TIME APPROVED
COMMENT
DATE
TIME
APPROVED
FINAL INSPECTION APPROVED BY
Building Inspector
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUilDING
OWNER'S SIGNATURE
BY
BUILDING DEPT.
APPLICATION FOR
_ BUILDING PERMIT a
CITY ~BREMERTON ~ BUILDING DEP~MENT
PHONE: 479--5281
/ 0 () ,. t'~ / -S "8 ".
\;~\II.Ur- $ (C? 5.;. ! .0. . .. PERM I T FEE $..;<!;3.. PLAN CHECK $.! ~4f. ~ RECE I PT . . ~7!r; f.If.:I...u
iJ~ 'f . '&I
OWNERlJ@~.. AI~411f"h4. ~e?'Tt7.A{G ADDRESS. . . . . . . . . . . . . . . . . . . . . . ... PHONE. %7/..~. f~~9.
Ji,
" .... ;~
<l
CONTRACTOR. . . . . . . . . .~e; .". . . . . . . . . . . . . . . . . . . . . . .. STATE LI C. #................
ADD RES s. . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .. . . . . . .. .. .. .. . .. .. .. .. .. .. .. .. .. .' P H 0 N E.. .. .. .. .. .. .1.. .. .. .. .. .. .. .
ADDRESS/LOCATION OF JOB. .1'?:-~... '. ~~ .G?-t$-.~:;~.I({J'.r;. .A~p~ .~~r.~........
PLANNING ZONINGA'" .;,r-..... ~. FR~NT .(...-z....... REAR............ SIDE.~i.;.......
OCCUPANCY.....S..~. FIR... ZONE.....,{..... TYPE OF CONSTRUCTION...~~-:A.......
APPLICATION ISSUED FOR: ...... .'L~~.i!2.)'(... .G\:-7... '~f:.:. @.t;Z.\};..................
. . . . . . . . -, . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SIGNATURE APPLICANT..~~.. ....... DATE.i5:-:l.-.'7.7.. RECEIVED BY u' ~.L..
PLANNING COMMENTS/REVIEWED BY.~'.... /W-#77 '. "
,.J,~v4v / ,~/~ ~1>'t(IU /-:;?;J-U:?C ~~vi ~~~~Jt?:~ f J: /f'~ c;tt~7~7 .
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ENGINEERING COMMENTS/REVI EWED BY/.~-....' '::~ yt)II~"CJ l,l/~~i' I
r ~ ct_ Jb~~{2;; , -~-:l~{ 111~~r~. "'$~ ~ S'tJ:e-p!a", IStt
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. ;;hI-J eX/~f.I' ~~ pnrposJ ~~>. J'-~"/I u ~J SL '",~~k. SIlH, ~W... !h/~ ~' ~~
FIRE DEPT. '~OMMENTS/REV I EWED BY... fl.<f...J'
TRAFFIC DEPT. COMMENTS/REVIEWED
-- ~
BY...,.......
BU I LD I NG DEPT. COW"tENTS: e,Wj:t!J~ 'ftJ PC oft!.,.
PLUMBING REVIEWED By..........
~ ~""I. . -i- 7.)"' .JI&e q;/~.e~..
ELECTRICAL REVIEWED By.......... CY~ '
BUILDING REVIEWED
!\ 17';1?D v ~ 9 __ 11 . . ~
ft- L r. ,(1/0 ~
"pi ~. rr/ ~
~,:; \0~ ~./
APPROVED BY COMMISSIONER OF PUBLIC WORKS
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .".
DA TE. . . . . . . . . . . . . . . . . . . ".